This provider's $3.2M in total Medicare payments ranks in the 99th percentile of Family Practice providers nationally.
Medicare payments to this provider grew 343% from 2019 to 2023.
AI-generated analysis based on Medicare payment data.
Notable: Payments increased 360% in 2020
Year-over-year payment surges can indicate changes in practice volume, new services, or billing pattern shifts.
Average per-service amounts submitted by the provider compared to what Medicare actually paid — the gap represents the markup.
| Year | Avg Submitted | Avg Paid | Markup Ratio | Gap per Service | Total Payments | Services | Beneficiaries |
|---|---|---|---|---|---|---|---|
| 2019 | $257.76 | $68.37 | 3.77x | $189.39 | $149.2K | 1.8K | 783 |
| 2020 | $288.26 | $75.46 | 3.82x | $212.80 | $686.5K | 8.4K | 2.4K |
| 2021 | $317.91 | $79.15 | 4.02x | $238.76 | $1.0M | 12.5K | 3.3K |
| 2022 | $325.88 | $83.71 | 3.89x | $242.17 | $668.9K | 8.5K | 2.9K |
| 2023 | $297.27 | $80.27 | 3.70x | $217.00 | $660.9K | 8.4K | 2.9K |
| Code | Description | Services | Payments | Avg/Service | Markup |
|---|---|---|---|---|---|
| 11043 | Removal of skin and/or muscle first 20 sq cm or less | 5.9K | $907.0K | $154.51 | 3.83x |
| 11042 | Removal of skin and tissue first 20 sq cm or less | 10.5K | $749.6K | $71.43 | 4.69x |
| 99309 | Subsequent nursing facility visit, typically 25 minutes per day | 7.7K | $554.6K | $72.30 | 3.10x |
| 99308 | Subsequent nursing facility visit, typically 15 minutes per day | 7.6K | $410.4K | $53.93 | 3.12x |
| 11044 | Removal of skin and bone first 20 sq cm or less | 1.2K | $263.5K | $219.58 | 3.62x |
| 99305 | Initial nursing facility visit, typically 35 minutes per day | 1.2K | $117.3K | $98.86 | 3.11x |
| 17250 | Application of chemical agent to excessive wound tissue | 3.5K | $104.3K | $29.44 | 7.88x |
| 99304 | Initial nursing facility visit, typically 25 minutes per day | 738 | $49.7K | $67.33 | 3.10x |
| 11046 | Removal of skin and/or muscle | 359 | $19.0K | $52.99 | 3.58x |
| 99307 | Subsequent nursing facility visit, typically 10 minutes per day | 358 | $11.3K | $31.60 | 3.12x |
| 11045 | Removal of skin and tissue | 278 | $7.7K | $27.63 | 3.77x |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 45 | $5.3K | $118.34 | 3.07x |
| 97597 | Removal of tissue from wound, 20.0 sq cm or less | 60 | $4.5K | $75.32 | 3.24x |
| 21550 | Biopsy of soft tissue of neck or chest | 20 | $4.0K | $202.50 | 3.52x |
| 11047 | Removal of skin and bone | 24 | $1.6K | $67.60 | 4.72x |
| G0406 | Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth | 50 | $1.5K | $30.05 | 3.34x |
| G0407 | Follow-up inpatient consultation, intermediate, physicians typically spend 25 minutes communicating with the patient via telehealth | 18 | $1.0K | $55.62 | 3.31x |
This provider submits charges 3.88 times higher than what Medicare actually pays.
A markup ratio of 3.88x means for every $100 Medicare pays, this provider initially charges $388. This is higher than the national average.
Always verify provider credentials and location before scheduling appointments. This data reflects Medicare payments and may not include all practice locations.
Share this provider's Medicare payment information
Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.
Believe this data is inaccurate? Dispute this data